Surname:
First and Middle Names:
U.S. Address: (P.O. Boxes not allowed)
City:
U.S. Phone Number:
State
Host Organization:
Host Phone Number:
Departure Date from the U.S.:
SEVIS ID Number:
found on the upper right side of your DS Form
Zip
U.S. E-mail Address
Apartment Number:
Is this a new address?
J-1 Work and Travel Final Monthly Check-in
IMPORTANT! This is your final monthly check in. Please be sure to submit prior to your departure!
Part of the J-1 Work and Travel Regulations require that you check in with your sponsor each month you are active on the program. This is a mandatory requirement. This form will provide you with an easy way to share your experiences as well as update us on any changes to your physical home or work address.
Please email this document to info@ieexchanges.com
Your cultural experiences while in the United States are a very important part of your Work and Travel program. Please share some of your best experiences of the summer. This can include different foods you have experienced, sports activities or different places you have seen.
Also, please let us know what you will miss most about the United States once you leave. Please send us pictures to be included on our Facebook page !
For a printable version of this form, CLICK HERE
Were you able to get a second job during your summer?
If yes, please provide the name of the business, supervisors name, supervisors email and the date you started
If you are eligible, would you like to return next summer?
Would you like to return to the same employer?
If yes, Name of Employer:
